Ask your AMA Guide questions to Dr. Chris Brigham. Christopher R. Brigham, MD is recognized as the nation's leading expert, author, and trainer on the Guides (www.impairment.com). We have expanded this category to include other rating questions under both new and old schedules.

IW is given work restrictions of sedentary work with use of crutches. On the ratings calculator there is a disability of "sedentary work with use of cane," however the AME specified the Lofstrand crutches. Would I rate the restriction to sedentary work separately from "use of crutches" and use the MDT?

I agree I would not rate sedentary and then rate crutches and finally MDT the two.

I recall seeing a rater rate this restriction as a 70% standard with either a 5% or a 10% add-on. Then a string was run out using either 75% or 80%.

The rater's reasoning was a person while sedentary can do some work in a weight bearing position, but that ability is more limited if they have 1 or 2 crutches in their hands. (Actually, it is usually 1 cane or 2 crutches. It is possible to use 1 crutch, but you seldom see it.)

Perhaps what I recall was 75% for sedentary + 1 cane or crutch and 80% for 2 crutches? I believe that is the case.

Last year I had my left foot operated on for a plantar facia(sp?) problem and was on crutches for about a month. It was a great relief to be able to easily bring a soda, sandwitch and chips to my recliner from the kitchen. The lack of an ability to carry even light things is more limiting than a person who has not experienced it might think!

Please refer the the 1997 PDRS Page 7-12. This page provides instruction on application on the Multiple Disabilities Table.

Combining Multiple Disabilities

Rules For Combining Disabilities Involving Different Parts of the Body

This section is to be used when combining multiple disabilities involving different members or systems of the body, for instance, when combining disabilities in an arm with disabilities in the back or a leg.